ZachEvans

Believer. Husband. Dad. Coach. Healthcare Thought-Leader. All-Around Good Guy.

Change

What Type of Person Are You?

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On a recent Wednesday night at Harpeth Hills, Scott Sager spoke to a gathering I was a part of and made a great point. He joked that his family heard him use this analogy so much that they could probably repeat it in their sleep.Nest Thermostat

There are two kinds of people in the world: thermometers and thermostats.

It took the class a bit of time to understand exactly where he was going with this until he had us define what a thermometer and a thermostat does.

A thermometer simply reflects the temperature of what ever environment it is in. A thermometer does not have the ability to change its environment.

A thermostat, on the other hand, resets the temperature of what ever environment it is in. A thermostat has the ability to change its environment as necessary, whether heating it up or cooling it down.

The best part? YOU get to choose which  you will be: A thermometer or a thermostat.

You can choose to be a manager that does nothing more than reflecting (and accepting) the situation around  you. Or you can be a leader that analyzes the situation and changes it as necessary.

I choose to be a thermostat. Which one will you choose?

CIOs As Change Agents

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I ran across a recent article that puts forth the idea that the CIO–and not the CEO–can most effectively drive transformation in organizations today. The main driver behind this supposition is that CIOs may be the one individual that sits at the crossroads of business needs and technical enablers and, therefore, when allowed, may be able drive change for effectively and efficiently than anyone else.

The authors identified four models (soldiers, leaders of IT, change consultants and transformation leaders) that, as CIOs move up a continuum based on complexity and risk, positions individuals to add greater value to the larger organization.

Journey Towards Transformation LeadershipThe sad reality, however, is that most CIOs are viewed only as leaders of IT and are not given the opportunity to add value. Granted, additional leadership responsibility should be earned and not just granted but organizations that have capable leaders occupying the CIO seat are doing themselves a disservice by not leveraging their leaders to the fullest extent possible.

What role could (or should) be better positioned to drive transformation than a leader with deep process knowledge, a will to leverage technology to streamline those processes, and a keen understanding of business needs?

Successful Transitions

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Transitions at work are never easy or simple. They are, however, a fact that every individual and organization will have to deal with at some point. Employees leave your team or organization. You choose to leave your team or organization. As the saying goes, the only constant in life is change.

When you are the individual making the move, I have found it to be helpful to create transition documents for both the position you are leaving and the position you are moving in to. The outgoing document will help the organization you are leaving know where you are leaving the work you were being paid to do and the incoming document will help you stay focused on creating a solid foundation for success in your new role.

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We All Shouldn’t Grow Up To Be Firefighters

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We have all done it. We smell the smoke, search for the fire, do everything we possibly can to put it out, and then fail to ever search for what caused the conflagration in the first place. We spend our careers (and sometimes our lives) moving from one crisis to another without even thinking of doing a root cause analysis. It is exciting, it is exhausting, and it is an excuse that keeps you from truly leading.

Seth Godin believes that we have too many emergency room doctors filling our offices around the world and I agree with him. As he puts it, “It’s a mindset, not just a job.” Truth is, we need people like this. Individuals that are great at stopping the bleeding and prepping the situation for the long-term solution that is needed. But what happens if we just stop at triage? The cut may be closed–we have stopped the bleeding–but we have yet to address what caused the injury in the first place.

Only being a firefighter (or only having the world view of the emergency room doctor) robs individuals (and organizations) of three things:

  1. You do not take the time to think. If all you do is react–and react quickly–you never take the opportunity to step back and evaluate what is really going on.
  2. You do not take the time to change. If you do not understand what is really going on, you will never have the opportunity to implement real and lasting change.
  3. You do not take the time to lead. If you are unable (or unwilling) to challenge the status quo and offer up changes, you will never really lead. You will simply manage.

We have become an instant-gratification society, one that is obsessed with the quick-fix. While this leads to early wins in the battles, it can often lead to long-term losses in the war. Are there times when we can do nothing more than react (both personally and professionally)? Absolutely. Should this be our default response to any and every challenge that comes our way? Absolutely not.

Summer Camp Love

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I love being outdoors but the idea of sleeping outside under the stars or in a tent has never been appealing to me. My father-in-law and two brothers-in-law hiked in to the Grand Canyon a few years back and they asked me if I was interested in going. While I loved the idea, I could not bring myself to the overnight camping part. I said, “Thanks, but no thanks”.

So my idea of summer camp included an air conditioned room and a soft bed. While I knew plenty of kids that trekked off to church camp to spend their days and night battling mosquitoes and sweating through shirt after shirt, I chose to attend Uplift and Impact. I would spend a Sunday through Friday on a university campus and sleeping in a dorm room while enjoying camp activities with hundreds of kids from around the country.

I was blessed to have several amazing experiences and met some pretty fantastic individuals. I also was exposed—on multiple occasions—to the feeling of summer camp love. If you’ve never experienced this phenomenon, it goes something like this:

  • Sunday: Arrive at camp
  • Monday: Meet a cute boy/girl
  • Tuesday: Spend an inordinate amount of time together
  • Wednesday: Hold hands and take a long walk during free time
  • Thursday: Have a first kiss
  • Friday: Have an emotional/tearful goodbye expressing undying love and promising to write EVERY DAY

At summer camp, you see, days are like weeks/months. They had to be because, at least for the camps I went to, we only had a week and for hormonal teens is an awfully long time. It helped me understand something at a very early age: Timelines are relative. It was an important lesson to learn.

Too often we get stuck in a rut thinking that processes and timelines are static. They are not, especially when it comes to change. Planning for change is essential and having an understanding of how change happens makes you more likely to be successful. Being dogmatic about a schedule for change, however, will only end in heartache and frustration.

As leaders, one of our greatest challenges is leading change (of any size and scope). Being able to differentiate between when a “summer camp love” schedule is appropriate and when a “glacier movement” schedule is needed is a key determinate of success.  The success-defining moment in leading change happens when you need to move like summer camp but your team wants to move like a glacier.

But more on motivation later…

The Grass Isn’t Always Greener

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If you’re in healthcare IT (or just IT in general) and you don’t already ready John Halamka’s blog, you really should. His recent post on The Perfect EHR is well worth the read for any IT leader fighting pressure from their business counterparts to replace an existing core system with something (anything) new.

It should also serve as a cautionary tale for senior executives thinking of approving a change just because a core constituency group keeps asking for it.

A really key point is made in the quote below:

…after listening to many “grass is greener” stories, I believe that what a provider perceives as a better EHR often represents trade offs in functionality. One EHR may have better prescribing functionality while another has better letters, another is more integrated and another has better support. The “best” EHRs, according to providers, varies by what is most important to that individual provider/practice, which may not be consistent with enterprise goals…There will always be dissatisfaction and a claim that something is better. However, I’ve never seen a change in product fix workflow and process issues.

In a soceity (both on a personal and professional level) that relies increasingly on techology, it is always tempting to think that the latest-and-greatest will solve all of my issues and problems. The fallacy with this thinking is that the underlying technology may not be the root cause or the final fix for what is actually wrong.

Technology companies, however, are really very good at holding up the shiny new toy in front of all of us and telling us that if you just have THIS all of your problems will go away. You very recently saw that with the iPhone 4S and at least one reporter is pointing out this exact same issue with the not-yet-released-but-rumored iPad 3.

(Disclosure: I am a very happy owner if an iPhone 4 and an iPad 2 and have no intention of upgrading either device any time soon.)

So, before you advocate for a rip-and-replace of software or even just a basic hardware upgrade ask yourself two questions:

  1. What do I truly stand to gain from the upgrade?
  2. Are there underlying process issues that, if corrected, would remove the perceived need to upgrade?

After all, as Model-Netics teaches us in Acres of Diamonds, the first place to look for a better opportunity (and outcome) is usually in your present situation.

A Well Designed EHR?

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A dirty little secret about a lot of EHR implementations is that there are often negative impacts on productivity post implementation. This is about much more than leading your team through the valley of despair associated with almost any change. This is about the fact that an EHR implementation fundamentally changes the way nurses and physicians actual practice. A recent article by Paul Roemer over at healthsystemCIO.com points out a very important reason for this:

You EHR was not designed to work efficiently in an non-linear exam. Chances are good that your EHR was never really designed at all. Were designers, professionals with advanced degrees in human factors — cognitive psychology, heuristics, taxonomy, and anthropology — asked to determine how the EHR would need to work? Did they watch users work prior to writing code? Did the EHR firm iteratively build prototypes and then measure how users used it in a research lab that tracked hand and eye movements? If not, that is why I think it is fair to characterize EHRs as having been built, not designed.

Most software, including EHRs, were built using linear logic. Step 1, Step 2, Step 3, etc. When you’re dealing with patients who often are scared, confused, in pain or all three (or more besides) linear logic breaks down. Healthcare providers need the ability–provided by their EHR–to jump around with the patient to make sure that everything gets documented as completely as possible in order to take advantage of all of the benefits that EHR offer. It’s also another good argument for the need for patient-centered EHRs.

Change for Change Sake?

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Are you an early adopter of…anything? Do like to have the latest and greatest of…everything? Do you live for the Zeitgeist? Do you even know what the Zeitgeist is?

How you answer these questions probably doesn’t matter. Why? Because change is all around us, is coming at us at an ever-increasing pace, and will be a huge part of your life (personal, professional, or otherwise) for a long time to come.

Adopting change isn’t important, however. What is important is how well you manage change. (And remember, there were early adopters of Betamax and HDDVD, too.)

UPDATE: A good article on why “Change is Good, But it’s Also Really Hard.”